Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Finals > Resp > Flashcards

Resp Flashcards

1
Q

how common is lung cancer

A

3rd in the UK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

types of NSCLC (80%) - other 20% is SCLC

A
  • Adenocarcinoma (40%) (peripheral)
  • SCC (20%) (central)
  • Large-cell carcinoma (10%)
  • Other types (10%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what do SCLC contain

A

neurosecretory granules that release neuroendocrine hormones. SCLC may be responsible for various paraneoplastic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is mesothelioma

A
  • related to asbestos
  • latent period of up to 45 years
  • poor prognosis: palliative
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

presentation of lung cancer

A
  • SOB
  • haemoptysis
  • clubbing
  • cough
  • recurrent pneumonia
  • FLAWS
  • supraclavicular LN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

extrapulmonary manifestations of lung cancer

A
  1. Recurrent laryngeal nerve palsy presents with a hoarse voice = tumout pressing on RLN
  2. phrenic nerve palsy = due to nerve compression, causes diaphragm weakness and SOB
  3. SVCO = facial swelling, SOB, Pemberton’s sign
  4. Horner’s = ptosis, miosis, anhidrosis. Pancoast tumour
  5. SIADH= ectopic ADH by SCLC, hyponatraemia
  6. Cushing’s = ectopic ACTH by SCLC
  7. hypercalcaemia= ectopic PTH by SCC
  8. limbic encephalitis= paraneoplastic syndrome
  9. lambert eaton
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

2ww lung cancer referral criteria

A
  • clubbing
  • supraclavicular LN
  • recurrent chest infection
  • thrombocytosis
  • chest signs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

CXR cancer signs

A
  • hilar enlargement
  • peripheral opacity
  • pleural effusion (unilateral)
  • collapse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Ix for lung cancer

A
  • staging CT
  • PET
  • bronchoscopy with EBUS
  • histological
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Mx of lung cancer

A

NSCLC
- surgery, radiotherapy, chemo

SCLC
- chemo and radiotherapy

endobronchial treatment with stents for palliative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

main thoracotomy incisions

A
  • anterolateral thoracotomy= incision around the front and side
  • Axillary thoracotomy = incision in the axilla
  • Posterolateral thoracotomy= incision back and side (most common)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Signs of URTI and LRTI

A

URTI- stridor
LRTI- wheeze

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

characteristic chest signs of pneumonia

A
  • Bronchial breath sounds (harsh inspiratory and expiratory breath sounds) due to consolidation around the airways
  • Focal coarse crackles caused by air passing through sputum in the airways
  • Dullness to percussion due to lung tissue filled with sputum or collapsed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

curb-65

A

Confusion
urea >7
RR >30
BP < 90/60
>65

0-1 mx at home
2: consider hospital
3: ITU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

causes of pneumonia

A
  • Streptococcus pneumoniae (most common)
  • Haemophilus influenzae
  • pseudomonas (CF/bronchiectasis)
  • staph Aureus (CF)
  • MRSA in HAP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

atypical pneumonia

A
  • legionella: air conditioning
  • mycoplasma: erythema multiforme
  • Coxiella burnetii: bodily fluids/animals
  • chlamydia psittaci: infected birds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

signs of klebsiella pneumonia

A
  • alcoholic and diabetic
  • currant jelly sputum
  • affects upper lobes bilaterally
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

PCP features

A
  • fungal pneumonia
  • in HIV and low CD4
  • dry cough, night sweats
  • prohylactic co-trimoxazole if low CD4
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Abx for mild CAP

A

5 days amox, doxy or clari

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Abx for moderate/severe pneumonia

A

IV abx
amoxicillin and a macrolide
7-10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

ABG for types of respiratory failure

A
  • Type 1: normal PaCO2 and low PaO2 (1 wrong)
  • Type 2: Raised PaCO2 and low PaO2 (2 wrong)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

ABG raised bicarbonate

A
  • chronic CO2 retainer.
  • Kidneys produced bicarbonate to balance acidosis takes time.
  • COPD patients
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

cause of resp alkalosis

A

hyperventilating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

cause of metabolic acidosis

A
  • raised lactate
  • raised ketones
  • increase hydrogen ions (renal failure)
  • reduce bicarbonate (diarrhoea)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

causes of metabolic alkalosis

A
  • vomiting
  • kidney increased activity of aldosterone increase H+ excretion (conn’s, cirrhosis, HF, diuretics)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is ARDS

A

due to severe inflammatory reaction in lungs often secondary to sepsis or trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

pathophysiology of ARDS

A
  • Collapse of the alveoli and lung tissue (atelectasis)
  • Pulmonary oedema (not related to heart failure or fluid overload)
  • Decreased lung compliance (reduced lung inflation when ventilated with a given pressure)
  • Fibrosis (typically after 10 days or more)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

clinical signs of ARDS

A
  • Acute respiratory distress
  • Hypoxia with an inadequate response to oxygen therapy
  • Bilateral infiltrates on a chest x-ray
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Mx of ARDS

A
  • resp support
  • prone positioning
  • fluid mx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is end expiratory pressure

A

pressure that remains in airway at end of exhalation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is PEEP

A

additional pressure at end of exhalation to keep lungs inflated
presents atelectasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

how is PEEP created

A
  • head bobbing in children
  • high flow NC
  • NIV
  • mechanical ventilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what does high flow O2 do to dead space

A

deadspace washout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what is CPAP

A

constant pressure to maintain airway adding PEEP to those who likely to collapse e.g. OSA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what is NIV

A
  • cycle of high and low pressure to correspond to the patient’s inspiration and expiration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

obstructive lung disease

A
  • FEV1 < 70% FVC so ratio of FEV1:FVC <70%
  • obstruction blocking air from getting out quickly
  • asthma: due to bronchoconstriction
  • COPD due to airway and lung damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

restrictive lung disease

A
  • FEV1 and FVC are equally reduced
  • FEV1:FVC ratio greater than 70%
  • FVC reduced to restriction of lung expansion + capacity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

restrictive lung diseases

A
  • Interstitial lung disease, such as idiopathic pulmonary fibrosis
  • Sarcoidosis
  • Obesity
  • Motor neurone disease
  • Scoliosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

atopic conditions

A
  • asthma
  • hayfever
  • eczema
  • food allergies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

asthma examination findings

A

polyphonic expiratory wheeze

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

differentials for localised monophonic wheeze

A
  • foreign body
  • tumour
  • mucus plug
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

medications that can worsen asthma

A
  • BB
  • NSAIDs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Ix for asthma

A
  • spirometry
  • reversibility with bronchodilator
  • FeNO (marker of airway inflammation)
  • peak flow
  • direct bronchial challenge testing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

moderate exacerbation of asthma

A

PEF 50-75%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

severe exacerbation of asthma

A
  • Peak flow 33-50%
  • Respiratory rate above 25
  • Heart rate above 110
  • Unable to complete sentences
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

life threatening asthma

A
  • Peak flow less than 33%
  • O2 < 92%
  • PaO2 less than 8 kPa
  • Becoming tired
  • Confusion or agitation
  • No wheeze or silent chest
  • Haemodynamic instability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

mx of acute asthma

A

Moderate
- bronchodilator via spacer up to 10 puffs

Severe
+ prednisolone 40mg
salbutamol 5mg nebuliser
O2 to maintain 94-98%

Life threatening
- nebulised bronchodilator with ipratropium bromide
- prednisolone 40-50mg
- ABG every hour
- can give IV mag sulphate
- IV aminophylline by senior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

long term management of asthma

A
  • low dose ICS/formoterol (AIR therapy)
  • low dose MART
  • moderate dose MART
  • check FeNO level
  • trial either LTRA or LAMA in addition to moderate dose MART for 8-12 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

side effect of salbutamol

A
  • hypokalaemia
  • tachycardia
  • lactic acidosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

mx post asthma exacerbation

A
  • optimise long term mx
  • asthma self management plan
  • prednisolon 40-50mg for 5 days
  • GP follow up within 2 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

what is COPD

A

long-term, progressive condition involving airway obstruction, chronic bronchitis and emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

most common organism causing infective exacerbations of COPD

A

haemophilus influenzae
then:
Streptococcus pneumoniae
Moraxella catarrhalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what is chronic bronchitis

A

long-term symptoms of a cough and sputum production due to inflammation in the bronchi.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

what is acute bronchitis

A

chest infection which is usually self-limiting in nature
inflammation of trachea and manjor bronchi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

mx of acute bronchitis

A

analgesia
good fluid intake
consider doxycycline if patient has co-morbities or very unwell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

what is emphysema

A

damage and dilatation of the alveolar sacs and alveoli, decreasing the surface area for gas exchange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

presentation of COPD

A
  • Shortness of breath
  • Cough
  • Sputum production
  • Wheeze
  • Recurrent respiratory infections, particularly in winter
  • NO CLUBBING, HAEMOPTYSIS OR CHEST PAIN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

MRC dyspnoea scale

A
  • Grade 1: Breathless on strenuous exercise
  • Grade 2: Breathless on walking uphill
  • Grade 3: Breathlessness that slows walking on the flat
  • Grade 4: Breathlessness stops them from walking > 100m on the flat
  • Grade 5: Can’t leave the house due to breathlessness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

severity of COPD

A
  • Stage 1 (mild): FEV1 > 80% of predicted
  • Stage 2 (moderate): FEV1 50-79% of predicted
  • Stage 3 (severe): FEV1 30-49% of predicted
  • Stage 4 (very severe): FEV1 less than 30% of predicted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

long term mx of COPD

A
  • stop smoking
  • pneumococcal and flu vax
  • pulmonary rehabiliation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

mx of COPD

A
  • SABA and ipratropium bromide
  • steroids
  • abx

no asthmatic/steroid responsive features
- LABA +LAMA

asthmatic/steroid responsive features
- LABA + ICS

final
- LABA, LAMA, ICS combo (trimbow)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

mx severe COPD

A
  • nebulisers (SABA+IB)
  • oral theophylline
  • mucolytics
  • prophylactix abx
  • oral steroids
  • NIV
  • doxapram (instead of NIV)
  • long term O2 therapy
63
Q

indications for NIV in COPD exacerbation

A
  • respiratory acidosis
64
Q

what is cor pulmonale

A

right sided heart failure caused by respiratory disease

65
Q

causes if cor pulmonale

A
  • COPD
  • Pulmonary embolism
  • Interstitial lung disease
  • Cystic fibrosis
  • Primary pulmonary hypertension
66
Q

sx of cor pulmonale

A
  • SOB
  • peripheral oedema
  • breathless on exertion
  • syncope
  • chest pain
67
Q

signs of cor pulmonale

A
  • Hypoxia
  • Cyanosis
  • Raised JVP
  • Peripheral oedema
  • Parasternal heave
  • Loud second heart sound
  • Murmurs (e.g., pan-systolic in tricuspid regurgitation)
  • Hepatomegaly due to back pressure in the hepatic vein (pulsatile in tricuspid regurgitation)
68
Q

Mx of cor pulmonale

A
  • diuretics
  • long term oxygen
  • poor prognosis
69
Q

contraindication to NIV

A

untreated pneumothorax

70
Q

white out on Xray indications

A
  • pneumonectomy
  • pleural effusion
  • consolidation
  • collapse
  • specific lesions e.g. tumours
    fluid e.g. pulmonary oedema
71
Q

white out hemithorax with Trachea pulled toward the white-out

A
  • Pneumonectomy
  • Complete lung collapse e.g. endobronchial intubation
  • Pulmonary hypoplasia
72
Q

white out hemithorax with Trachea central

A
  • consolidation
  • pulmonary oedema
  • mesothelioma
73
Q

white out hemithorax with Trachea pushed away from the white-out

A
  • Pleural effusion
  • Diaphragmatic hernia
  • Large thoracic mass
74
Q

Pleural effusion causes

A

transudate
or exudative

75
Q

transudative causes of pleural effusion (< 30g/L protein)

A
  • heart failure (most common)
  • hypoalbuminaemia
  • liver disease
  • nephrotic syndrome
  • malabsorption
  • hypothyroidism
  • Meigs’ syndrome
76
Q

what is Meig’s syndrome

A

triad of:
1. benign ovarian tumour (usually a fibroma)
2. pleural effusion
3. ascites

77
Q

exudative causes of pleural effusion (>30g/L protein)

A
  • infection: pneumonia (most common), TB, subphrenic abscess
  • connective tissue disease
  • rheumatoid arthritis
  • SLE
  • neoplasia
  • cancer: lung+mesothelioma
  • metastases
  • pancreatitis
  • pulmonary embolism
  • Dressler’s syndrome
  • yellow nail syndrome
78
Q

Light’s criteria for establishing an exudative effusion

A
  • Pleural fluid protein / serum protein greater than 0.5
  • Pleural fluid LDH / serum LDH greater than 0.6
  • Pleural fluid LDH greater than 2/3 of the normal upper limit of the serum LDH
79
Q

presentation of pleural effusion

A
  • SOB
  • dullness to percussion
  • reduced breath sounds
  • tracheal deviation away
80
Q

Mx of pleural effusion

A

small= conservative
larger= aspiration or chest drain

81
Q

what is empyema

A

infected pleural effusion
mx- chest drain + abx

82
Q

causes of pneumothorax

A
  • spontaneous
  • trauma
  • iatrogenic
  • ashtma, COPD, infection
83
Q

ix for pneumothorax

A

erect CXR

84
Q

Pneumothorax mx

A

no/minimal sx- conservative
if sx assess for high risk characteristics:
- haemodynamic compromise
- significant hypoxia
- bilateral pneumothorax
- underlying lung disease
- ≥ 50 years of age with smoking hx
- haemothorax

85
Q

conservative mx of pneumothorax

A
  • primary spontaneous pneumothorax = review every 2-4 days as an outpatient
  • secondary spontaneous pneumothorax= monitor as an inpatient
    If stable, follow-up in the outpatients department in 2-4 weeks
86
Q

mx of patients with high risk characterisitics and pneumothorax

A
  • generally need chest drain
87
Q

mx of low risk pt w pneumothorax

A

<2m = conservative
>2cm= patient priority
conservative, ambulatory device or needle aspiration/chest drain

88
Q

ambulatory care of pneumothorax

A
  • catheter in pleural space
  • devices have a one-way valve and vent to prevent air and fluid return to the pleural space while allowing for controlled escape of air and drainage of fluid
  • can be an outpatient
89
Q

where to insert chest drain

A
  • 5th intercostal space (or the inferior nipple line)
  • Midaxillary line (or the lateral edge of the latissimus dorsi)
  • Anterior axillary line (or the lateral edge of the pectoralis major)

insert ABOVE RIB to avoid neurovascular bundle

90
Q

mx of persistent/recurrent pneumothorax

A

video-assisted thoracoscopic surgery (VATS)

91
Q

fit to fly after pneumothorax

A

can travel 2 weeks after successful drainage

92
Q

chest drain swinging in the right place sign

A
  • water level rise on inspirations and falls on expiration
93
Q

complications of chest drain

A

air leak
surgical emphysema

94
Q

signs of tension pneumothorax

A
  • Tracheal deviation away from the side of the pneumothorax
  • Reduced air entry on the affected side
  • Increased resonance to percussion on the affected side
  • Tachycardia
  • Hypotension
95
Q

Mx of tension pneumothorax

A

Insert a large bore cannula into the second intercostal space in the midclavicular line.”
Can also do fourth or fifth intercostal space, anterior to the midaxillary line

Chest drain is definitive mx

96
Q

what is bronchiectasis

A

permanent dilation of the bronchi
sputum collects–>chronic cough–>infection

97
Q

causes of bronchiectasis

A
  • Idiopathic
  • Pneumonia
  • Whooping cough
  • Tuberculosis
  • Alpha-1-antitrypsin deficiency
  • Connective tissue disorders (e.g., rheumatoid arthritis)
  • Cystic fibrosis
  • Yellow nail syndrome
98
Q

sx of bronchiectasis

A
  • SOB
  • chronic productive cough
  • recurrent chest infection
  • weight loss
99
Q

signs of bronchiectasis on examination

A
  • Sputum pot by the bedside
  • Oxygen therapy (if needed)
  • Weight loss (cachexia)
  • Finger clubbing
  • Signs of cor pulmonale
  • Scattered crackles throughout the chest that change or clear with coughing
  • Scattered wheezes and squeaks
100
Q

most common organism in bronchiectasis

A

haemophilus influenza
pseudomonas aeruginosa

101
Q

Xray findings in bronchiectasis

A
  • tram track opacities
  • ring shadows (dilated airways)
    High res ST gold standard
102
Q

mx of bronchiectasis

A
  • pneumococcal + flu vax
  • chest physio
  • pulmonary rehab
  • long term abx (azithromycin)
  • inhaled colistin for pseudo
  • long term oxygen
  • surgical lung resection
  • lung transplant
103
Q

mx of infective exacerbation of bronchiectasis

A
  • sputum culture
  • abx 7-14 days
  • ciprofloxacin if pseudomonas cause
104
Q

Mx of atelectasis

A

chest physio and reposition

105
Q

Conditions causing upper zone fibrosis

A

CHARTS
C - Coal worker’s pneumoconiosis
H - Histiocytosis/ hypersensitivity pneumonitis
A - Ankylosing spondylitis
R - Radiation (usually 6-12 months post)
T - Tuberculosis
S - Silicosis/sarcoidosis

106
Q

conditions causing lower zone fibrosis

A

A - asbestos.
C - connective tissue diseases (exc Ankylosing Spondylitis)
I - idiopathic pulmonary fibrosis.
D - drugs e.g. methotrexate, nitrofurantoin, bleomycin, amiodarone

107
Q

when is bupropion contraindicated

A

PMH of seizures, lowers seizure threshold

108
Q

conditions causing interstitial lung disease

A

inflammation and fibrosis of lung parenychma

  • Idiopathic pulmonary fibrosis (the most important)
  • Secondary pulmonary fibrosis
  • Hypersensitivity pneumonitis
  • Cryptogenic organising pneumonia
  • Asbestosis
109
Q

presentation if ILD

A
  • SOB
  • dry cough
  • fatigue
110
Q

examination findings of IPF

A

bibasal fine end inspiratory crackles
clubbing

111
Q

how to diagnose ILD

A
  • clinical features
  • HRCT
  • spirometry (normal or restrictive)
112
Q

mx of ILD

A
  • poor prognosis
  • oxygen
  • treat cause
  • stop smoking
  • rehab
  • vaccines
  • advanced care planning
  • lung transplant
113
Q

what is IPF

A

PF with no cause
insidious onset >3months
>50y/o
2-5 yr life expectancy

114
Q

medication to slow IPF

A
  • pirfenidone
  • nintedanib
115
Q

Causes of secondary PF

A
  • A1AD
  • RA and SLE
  • systemic sclerosis
  • sarcoidosis

Drugs
- Amiodarone
- Cyclophosphamide
- Methotrexate
- Nitrofurantoin

116
Q

what is hypersensitivity pneumonitis

A

type 3 and 4 hypersensitivity reaction

117
Q

example of hypersensitivity pneumonitis

A
  • Bird-fancier’s lung is a reaction to bird droppings
  • Farmer’s lung is a reaction to mouldy spores in hay
  • Mushroom worker’s lung is a reaction to specific mushroom antigens
  • Malt worker’s lung is a reaction to mould on barley
118
Q

What can asbestosis cause?

A
  • lung fibrosis
  • Pleural thickening and pleural plaques
  • Adenocarcinoma
  • Mesothelioma
119
Q

what is a PE

A

thrombus in the pulmonary arteries

120
Q

RFs for PE

A
  • immobility
  • recent surgery
  • long haul flight
  • pregnancy
  • HRT w oestrogen, COCP
  • malignancy
  • polycythaemia
  • thrombophilia
  • SLE
121
Q

VTE prophylaxis

A

LMWH
TED stockings

122
Q

presentation of PE

A
  • SOB
  • Cough
  • Haemoptysis
  • Pleuritic chest pain
  • Hypoxia
  • Tachycardia
  • Raised respiratory rate
  • Low-grade fever
  • Haemodynamic instability
  • leg swelling
123
Q

Wells score

A

probability of a patient having a PE

124
Q

PERC rule

A

rules out PE

125
Q

Diagnosing PE

A

Wells score
likely= CTPA or VQ
unlikely= D dimer, if positive then CTPA

126
Q

Mx of PE

A
  • O2, analgesia
  • DOAC
  • LMWH if DOAC unsuitable
  • massive PE= IV unfractionated heparin adn thrombolysis
127
Q

Long term mx of PE

A

anticoag for 3 months if cause
6 months if no cause
3-6 months if active cancer

128
Q

what is pulmonary hypertension

A

increased resistance and pressure in the pulmonary arteries

129
Q

causes of pulmonary hypertension

A
  • Group 1 – Idiopathic or connective tissue disease (e.g., systemic lupus erythematous)
  • Group 2 – Left heart failure, usually due to MI or systemic hypertension
  • Group 3 – Chronic lung disease (e.g., COPD or pulmonary fibrosis)
  • Group 4 – Pulmonary vascular disease (e.g., pulmonary embolism)
  • Group 5 – Miscellaneous causes such as sarcoidosis, glycogen storage disease and haematological disorders
130
Q

Mx of pulmonary hypertension

A

idiopathic- poor prognosis
- CCB, IV prostaglandin, sildenafil, endothelin receptor antagonists

secondary= treat cause

131
Q

what is sarcoidosis

A

chronic granulomatous disorder
Granulomas= inflammatory nodules full of macrophages. The cause of these granulomas is unknown
can affect any organ

132
Q

sarcoidosis demographic

A
  • Aged 20-39 or around 60
  • Women
  • Black ethnic origin
133
Q

signs of sarcoidosis

A
  • resp sx
  • erythema nodosum
  • lymphadenopathy
  • lupus pernio
  • FLAWS
134
Q

organs affects in sarcoidosis

A
  • lungs: mediastinal lymphadenopathy, fibrosis, nodules
  • eyes: uveitis, conjunctivitis, optic neuritis
  • liver: nodules, cirrhosis, cholestasis
  • heart: heart block
  • kidney: stones, nephrocalcinosis, interstitial nephritis
  • CNS: nodules, pituitary, encephalopathy
  • PNS: facial nerve palsy
  • Bones: arthralgia, aarthritis, myopathy
135
Q

what is Lofgren’s syndrome

A

specific presentation of sarcoidosis. Triad:
- Erythema nodosum
- Bilateral hilar lymphadenopathy
- Polyarthralgia

136
Q

Ix for sarcoidosis

A
  • Bloods: raised ACE and calcium
  • CXR: hilar lymphadenopathy
137
Q

Mx of sarcoidosis

A

conservative
- 1st line: steroids + bisphosphonates
- 2nd line: methotrexate
- lung transplant

138
Q

prognosis of sarcoidosis

A

spontaneously resolves in 50%
others progresses to pulmonary fibrosis and hypertension

139
Q

what is OSA

A

collapse of the pharyngeal airway
stop breathing

140
Q

RF for OSA

A
  • men
  • middle age
  • obesity
  • alcohol
  • smoking
141
Q

presentation of OSA

A
  • Episodes of apnoea
  • Snoring
  • Morning headache
  • Waking up unrefreshed
  • Daytime sleepiness
  • Concentration problems
  • Reduced O2 during sleep
  • severe= HTN and HF
142
Q

how to assess OSA

A

Epworth Sleepiness Scale
Sleep studies

143
Q

Mx of OSA

A
  • address reversible RFs
  • CPAP
  • mouth guard
  • surgery: uvulopalatopharyngoplasty (UPPP)9
144
Q

where is emphysema most prominent

A

lower lobes- A1AD
upper lobes- COPD

145
Q

bupropion mechanism of action

A

Norepinephrine and dopamine reuptake inhibitor, and nicotinic antagonist

146
Q

varenicline mechanism of action

A

nicotinic receptor partial agonist

147
Q

what is kartagener’s syndrome

A

primary ciliary dyskinesia

features:
- dextrocardia or complete situs inversus
- bronchiectasis
- recurrent sinusitis
- subfertility

148
Q

demographic for adenocarcinoma

A

women and non-smokers
metastasise early
peripheral
gynaecomastia and hypertrophic pulmonary osteoarthropathy

149
Q

demographic for SCC

A

central
smoker
M>F
late metastasis

150
Q

what virus is covid-19

A

severe acute respiratory syndrome coronavirus 2

151
Q

presentation of covid-19

A

ranging from a mild common cold-like illness, to a severe viral pneumonia leading to acute respiratory distress syndrome
- fever
- cough
- dyspnoea
- anosmia

152
Q

complications of covid-19

A

multi-organ failure, septic shock, and VTE, long covid

153
Q

Ix for covid-19

A

RT-PCR
rapid antigen testing (lateral flow)
O2
ABG

154
Q

Mx for covid-19

A

isolating
self-limiting
dexamethasone
oxygen, antivirals

Finals (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions